Provider Demographics
NPI:1700935624
Name:THOMAS, ROY R (LCSW)
Entity type:Individual
Prefix:
First Name:ROY
Middle Name:R
Last Name:THOMAS
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9165 MORTON ST
Mailing Address - Street 2:
Mailing Address - City:MERRILLVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46410-8622
Mailing Address - Country:US
Mailing Address - Phone:219-771-4776
Mailing Address - Fax:601-510-8985
Practice Address - Street 1:9165 MORTON ST
Practice Address - Street 2:
Practice Address - City:MERRILLVILLE
Practice Address - State:IN
Practice Address - Zip Code:46410-8622
Practice Address - Country:US
Practice Address - Phone:219-771-4776
Practice Address - Fax:601-510-8985
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-09
Last Update Date:2025-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34004378A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical